Quality of care in public sector family planning services in KwaZulu-Natal, South Africa: a qualitative evaluation from community and health care provider perspectives

Abstract Background Quality of care is a multidimensional concept that forms an integral part of the uptake and use of modern contraceptive methods. Satisfaction with services is a significant factor in the continued use of services. While much is known about quality of care in the general public he...

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Autores principales:	Yolandie Kriel, Cecilia Milford, Joanna Paula Cordero, Fatima Suleman, Petrus S. Steyn, Jennifer Ann Smit
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Quality of care Family planning services Contraception South Africa Qualitative research Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/e6fbc0c9f72346e7a7e60fd02fadfe80
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spelling	oai:doaj.org-article:e6fbc0c9f72346e7a7e60fd02fadfe802021-11-21T12:06:15ZQuality of care in public sector family planning services in KwaZulu-Natal, South Africa: a qualitative evaluation from community and health care provider perspectives10.1186/s12913-021-07247-w1472-6963https://doaj.org/article/e6fbc0c9f72346e7a7e60fd02fadfe802021-11-01T00:00:00Zhttps://doi.org/10.1186/s12913-021-07247-whttps://doaj.org/toc/1472-6963Abstract Background Quality of care is a multidimensional concept that forms an integral part of the uptake and use of modern contraceptive methods. Satisfaction with services is a significant factor in the continued use of services. While much is known about quality of care in the general public health care service, little is known about family planning specific quality of care in South Africa. This paper aims to fill the gap in the research by using the Bruce-Jain family planning quality of care framework. Methods This formative qualitative study was conducted in South Africa, Zambia, and Kenya to explore the uptake of family planning and contraception. The results presented in this paper are from the South African data. Fourteen focus group discussions, twelve with community members and two with health care providers, were conducted along with eight in-depth interviews with key informants. Thematic content analysis using the Bruce-Jain Quality of Care framework was conducted to analyse this data using NVIVO 10. Results Family planning quality of care was defined by participants as the quality of contraceptive methods, attitudes of health care providers, and outcomes of contraceptive use. The data showed that women have limited autonomy in their choice to either use contraception or the method that they might prefer. Important elements that relate to quality of care were identified and described by participants and grouped according to the structural or process components of the framework. Structure-related sub-themes identified included the lack of technically trained providers; integration of services that contributed to long waiting times and mixing of a variety of clients; and poor infrastructure. Sub-themes raised under the process category included poor interpersonal relations; lack of counselling/information exchange, fear; and time constraints. Neither providers nor users discussed follow up mechanisms which is a key aspect to ensure continuity of contraceptive use. Conclusion Using a qualitative methodology and applying the Bruce-Jain Quality of Care framework provided key insights into perceptions and challenges about family planning quality of care. Identifying which components are specific to family planning is important for improving contraceptive outcomes. In particular, autonomy in user choice of contraceptive method, integration of services, and the acceptability of overall family planning care was raised as areas of concern.Yolandie KrielCecilia MilfordJoanna Paula CorderoFatima SulemanPetrus S. SteynJennifer Ann SmitBMCarticleQuality of careFamily planning servicesContraceptionSouth AfricaQualitative researchPublic aspects of medicineRA1-1270ENBMC Health Services Research, Vol 21, Iss 1, Pp 1-16 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Quality of care Family planning services Contraception South Africa Qualitative research Public aspects of medicine RA1-1270
spellingShingle	Quality of care Family planning services Contraception South Africa Qualitative research Public aspects of medicine RA1-1270 Yolandie Kriel Cecilia Milford Joanna Paula Cordero Fatima Suleman Petrus S. Steyn Jennifer Ann Smit Quality of care in public sector family planning services in KwaZulu-Natal, South Africa: a qualitative evaluation from community and health care provider perspectives
description	Abstract Background Quality of care is a multidimensional concept that forms an integral part of the uptake and use of modern contraceptive methods. Satisfaction with services is a significant factor in the continued use of services. While much is known about quality of care in the general public health care service, little is known about family planning specific quality of care in South Africa. This paper aims to fill the gap in the research by using the Bruce-Jain family planning quality of care framework. Methods This formative qualitative study was conducted in South Africa, Zambia, and Kenya to explore the uptake of family planning and contraception. The results presented in this paper are from the South African data. Fourteen focus group discussions, twelve with community members and two with health care providers, were conducted along with eight in-depth interviews with key informants. Thematic content analysis using the Bruce-Jain Quality of Care framework was conducted to analyse this data using NVIVO 10. Results Family planning quality of care was defined by participants as the quality of contraceptive methods, attitudes of health care providers, and outcomes of contraceptive use. The data showed that women have limited autonomy in their choice to either use contraception or the method that they might prefer. Important elements that relate to quality of care were identified and described by participants and grouped according to the structural or process components of the framework. Structure-related sub-themes identified included the lack of technically trained providers; integration of services that contributed to long waiting times and mixing of a variety of clients; and poor infrastructure. Sub-themes raised under the process category included poor interpersonal relations; lack of counselling/information exchange, fear; and time constraints. Neither providers nor users discussed follow up mechanisms which is a key aspect to ensure continuity of contraceptive use. Conclusion Using a qualitative methodology and applying the Bruce-Jain Quality of Care framework provided key insights into perceptions and challenges about family planning quality of care. Identifying which components are specific to family planning is important for improving contraceptive outcomes. In particular, autonomy in user choice of contraceptive method, integration of services, and the acceptability of overall family planning care was raised as areas of concern.
format	article
author	Yolandie Kriel Cecilia Milford Joanna Paula Cordero Fatima Suleman Petrus S. Steyn Jennifer Ann Smit
author_facet	Yolandie Kriel Cecilia Milford Joanna Paula Cordero Fatima Suleman Petrus S. Steyn Jennifer Ann Smit
author_sort	Yolandie Kriel
title	Quality of care in public sector family planning services in KwaZulu-Natal, South Africa: a qualitative evaluation from community and health care provider perspectives
title_short	Quality of care in public sector family planning services in KwaZulu-Natal, South Africa: a qualitative evaluation from community and health care provider perspectives
title_full	Quality of care in public sector family planning services in KwaZulu-Natal, South Africa: a qualitative evaluation from community and health care provider perspectives
title_fullStr	Quality of care in public sector family planning services in KwaZulu-Natal, South Africa: a qualitative evaluation from community and health care provider perspectives
title_full_unstemmed	Quality of care in public sector family planning services in KwaZulu-Natal, South Africa: a qualitative evaluation from community and health care provider perspectives
title_sort	quality of care in public sector family planning services in kwazulu-natal, south africa: a qualitative evaluation from community and health care provider perspectives
publisher	BMC
publishDate	2021
url	https://doaj.org/article/e6fbc0c9f72346e7a7e60fd02fadfe80
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Quality of care in public sector family planning services in KwaZulu-Natal, South Africa: a qualitative evaluation from community and health care provider perspectives

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